Typical case: the patient Liu, male, 27 years old, due to penile foreskin blisters itching recurrent episodes for more than 2 years. The patient complained of small blisters on the foreskin of the penis, accompanied by burning and itching without pain, which appeared 2 years ago after unclean sex, and was diagnosed as genital herpes in the local hospital, and the symptoms disappeared soon after oral antiviral medication and topical Penciclovir cream were used. Subsequently every two months or so an attack, each attack is manifested as small blisters on the foreskin, quickly broken, about 5 days since the healing, repeated episodes. This time, 2 days after the onset of the attack, the doctor asked for a complete treatment. Check: the dorsal side of the foreskin can be seen skin ulcers, an area of about 0.5 * 0.3cm, a small amount of oozing, no obvious blisters, the surrounding skin is not red, no obvious tenderness. The tongue was pale red, the moss was thin and yellow, and the pulse was fine. Clinical diagnosis was genital herpes. Consider the patient for kidney qi insufficiency, obscene poisonous evil not exhausted due. The treatment is to tonify the kidneys, supplemented by detoxification and removal of dampness. The formula is Zhi Bai Di Huang Tang plus Semen Ziziphi Lian, Snake Tongue Herb, Panax Quinquefolium, Da Qing Ye and so on. Orally take famciclovir 250mg twice a day. Topical use of heavy 1% Penciclovir cream and recombinant human interferon α2b ointment. The medication was used for three months without recurrence, and is now discontinued with no sign of recurrence after another three months of observation. The above is a typical case of recurrent genital herpes, recently I received a number of similar patients, in the process of patients often have a lot of questions, in order to allow patients and friends to better understand genital herpes, today on the frequently asked questions to tell you. 1. What is genital herpes? Genital herpes that occurs in the genital area of herpes simplex, is a viral infectious skin disease, Chinese medicine belongs to the category of feverish sores. Although genital herpes also belongs to herpes simplex, it is different from herpes simplex that occurs in the corners of the mouth, because it is transmitted through sexual relations in most cases. The incidence of genital herpes is significantly higher in sexually active areas of the country and abroad than in other places, as shown in some reports. 2. What are the manifestations of genital herpes? The clinical manifestations of incipient genital herpes and recurrent genital herpes are not exactly the same. 1) The first outbreak of genital herpes is usually about 1 week after unclean sex, the main manifestation is the external genitals or around the anus in clusters or scattered small blisters, 2 to 4 days after the breakthrough to form vesicles or ulcers, self-conscious pain. There will usually be inguinal lymph nodes are often enlarged, and the pressure pain is obvious. Some patients also have systemic symptoms such as fever, headache, and fatigue. The course of the disease is usually 2~3 weeks. 2) the initial genital herpes lesions subside after the rash recurrence is recurrent genital herpes, recurrent genital herpes than the primary systemic symptoms and lesions are mild, the course of the disease is shorter. Generally before the rash, patients will obviously feel localized burning sensation, pinprick sensation or sensory abnormalities. Its main manifestation is also clusters of small blisters around the external genitals or anus, but will soon break down to form vesicles or shallow ulcers, self-conscious symptoms are mild. The course of the disease is generally 7~10 days. 3. Many patients who know that they have genital herpes will usually have a question: why do you have this disease? Genital herpes is mainly transmitted from an infected person to his or her sexual partner through sexual contact, and men who have sex with men are also an important cause of transmission of the disease. Often some patients will say that there is no genital contact, only oral sex why will be infected, in fact, the lips and around the herpes people, can be through the mouth – genital intercourse, so that the other party infected with genital herpes (so you later in the choice of oral sex when you have to observe the other side of the lips and around the herpes Oh). Because of the infectious virus can survive in a moist environment for several hours, and therefore may also be in a few cases through the pollutants and indirect transmission (this is after all only a few, so patients and friends do not always take the indirect transmission as an excuse Oh, after all, do people still want to dare to do it well). 4. How to diagnose genital herpes? Generally with the history and typical clinical manifestations can make a diagnosis (so in the doctor asked the history of the time we try not to hide oh). If necessary, it should be combined with the results of laboratory tests to make a comprehensive judgment and make a diagnosis. 5. What tests should be done? Generally need to do the following kinds of tests, but sometimes according to the history and clinical manifestations can be a clear diagnosis there is no need to do so many tests (specific case specific treatment) 1) cytological examination (Tzanck smear): a slide in the blisters for the bottom of the print, Wright staining or Giemsa staining, under the microscope, can be seen with characteristic multinucleated giant cells or intranuclear viral Inclusion bodies can be seen under the microscope. 2) Detection of viral antigen: Specimens were taken from the lesions, and herpes simplex virus antigen was detected by monoclonal antibody direct fluorescence method or enzyme-linked immunosorbent assay (ELISA). 3) Virus culture: Specimens are taken from skin lesions for virus culture to detect herpes simplex virus and cytopathic lesions. 4) Nucleic acid test: HSV-2 nucleic acid is detected by polymerase chain reaction (PCR) and other methods. 6. Treatment of genital herpes Since the diagnosis has been made, then how to treat it has become the most concerned issue, genital herpes is not a terminal disease, but the treatment is not very simple, the current treatment methods can not yet achieve in a short period of time to completely remove the virus, eliminate the recurrence of the effect, the purpose of the treatment is mainly to alleviate the symptoms, reduce the pain, shorten the course of the disease and prevent secondary infections and so on. In recent years, I have received more patients, for this reason, I have developed my own combination of Chinese and Western medicine treatment program, so far the vast majority of patients can achieve clinical cure. 1) Western medical treatment Mainly adopts antiviral treatment. Acyclovir is preferred, followed by valaciclovir and famciclovir. If it is the first incidence of genital herpes, the course of treatment is 7 to 10 days; recurrent genital herpes course of treatment is 5 days. Those with frequent recurrences will need to take a longer course at a lower dose. At the same time, interferon can be injected intramuscularly or subcutaneously to inhibit the replication of the virus. 2) Traditional Chinese Medicine (TCM) Herpes genitalis belongs to the category of fever sores in TCM. According to TCM, its pathology is hot and solid in the early stage, which is dampness, heat and toxic fire blocking the liver vein; and in the later stage, it is accompanied by deficiency of the liver and kidney. Treatment is mainly based on symptoms, signs, combined with the tongue and pulse, generally divided into three types of the disease, namely, damp-heat injection, toxic heat stagnation, kidney qi insufficiency, respectively, to give different treatments. (1) Genital herpes belonging to the syndrome of damp-heat under injection, common genital area blisters in clusters, surrounded by a red halo, or vesicles, with light itching, visible urine yellow and red, bitter mouth, thirst, red tongue with yellowish greasy coating, and slippery pulse. This is due to the day like fat, sweet, spicy products, or addicted to tobacco and alcohol, damage to the spleen and stomach, the spleen is not healthy, water and dampness within the accumulation of heat, and the evil of dampness and heat injected into the liver meridian caused. Dampness and heat accumulate in the lower jiao, injected into the pubic area, hair as genital herpes. Treatment should be to clear heat and remove dampness, the formula is often gentian diarrhea liver soup plus reduction. (2) Genital herpes belonging to the toxic-heat accumulation syndrome, see the pubic herpes large and red, localized swelling, pain obvious, inguinal lymph nodes enlarged, or have a low-grade fever, urination difficulties, tongue red and red, pulse slippery. This is due to unclean sexual intercourse, external infection of obscene poison, poisonous heat agglomeration of the pubic area, embedded in the local skin and mucous membrane caused. The treatment method is appropriate to clear the heat and detoxification, often with the formula for clearing the poisonous sacred soup plus subtractions. (3) belonging to the genital herpes of kidney qi deficiency syndrome, common in recurrent pubic herpes, herpes dry small, no self-conscious symptoms, but often recurring. This is due to the insufficiency of kidney qi, the evil of obscene poison has not been exhausted. The law of treatment is based on tonifying the kidney, supplemented by detoxification and removal of dampness. Commonly used prescription for six flavors of dihuang pill plus reduction. 3) Local treatment Keep the affected area clean and dry. Apply 3% acyclovir cream, 1% penciclovir cream and recombinant human interferon α2b ointment on the skin lesions. If there is secondary bacterial infection, antibiotics should be added. 7. How to prevent genital herpes? 1) avoid unclean sexual intercourse and improper sexual relations, active genital sores patients are absolutely prohibited from having sexual relations with anyone; 2) during the treatment period, intercourse is prohibited, if necessary, the spouse should also be examined; 3) the care of local damage, attention should be paid to keep clean and dry, to prevent secondary infections; 4) after the cure or recurrence of the person, we should pay attention to the prevention of colds, colds, fatigue, and other triggering factors, in order to reduce the recurrence of the disease. 5) When someone at home has genital herpes, the patient’s underwear, bed linen and utensils contaminated by the patient’s secretions can be sterilized by boiling or soaking in disinfectant solution. 8. Dietary contraindications for patients with genital herpes. 1) prohibit eating fat and sweet greasy products: fat meat, caramel, milk and sweet food, more nourishing, fat and sweet obstruction of the nature of herpes, easy to make the herpes of dampness and heat toxicity within the evil does not reach, the condition of the lingering not healed. This is the genital herpes diet taboo. 2) prohibit spicy warm food: such as wine, cigarettes, ginger, chili peppers, mutton, beef and fried food and other spicy warm products, easy to help fire heat after eating. Chinese medicine thinks, this disease for dampness, heat and fire poison accumulation skin born, so herpes patients should avoid eating the above spicy heat-causing food. 9. Health education 1) Emphasize that patients should inform their sexual partners of their condition, obtain the understanding and cooperation of their sexual partners, and avoid sexual contact at the time of recurrence of prodromal symptoms or appearance of lesions, or better use of barrier contraception, in order to reduce the risk of transmission of HSV to the sexual partner; 2) Promote barrier contraception, such as condoms, which can reduce the risk of transmission of genital herpes, but sexual intercourse at the time of appearance of lesions, even if the use of condoms may also occur. However, sexual intercourse when skin lesions appear, even if condoms are used, HSV sexual transmission may still occur; 3) Changing the way of sexual behavior, avoiding non-marital sex, and eliminating multiple sexual partners are fundamental to the prevention of genital herpes.